Too sick for school?

Early in the morning is often a difficult time to make the decision whether or not your child is too sick to go to school. With minor symptoms you often cannot tell if they are going to get better or worse during the course of the day. 

The main reasons for keeping your child home are: 
1) They are too sick to be comfortable at school, or 
2) They might spread a contagious disease to other children. 

As a rule of thumb, a child who has a fever, vomiting, diarrhea, a very frequent cough, persistent pain (ear, stomach, headache, etc.), or a wide-spread rash should stay home. Most of these problems need to be discussed with your child’s health care provider to determine if an office visit is needed. 

On the other hand, children who don’t have a fever and only have a mild cough, runny nose, or other cold symptoms can be sent to school without any harm to themselves or others. The following guidelines may help in you decision-making process: 

Runny or stuffy nose - If your child is exhibiting the classic symptoms of a mild head cold (runny or stuffy nose, slight cough and watery eyes) but does not have a fever, there is no reason she can’t go to school. Be sure to instruct her to take proper hygienic precautions to prevent sharing the germs with her classmates, including frequent hand washing, covering her mouth when coughing or sneezing, and refraining from sharing eating and drinking utensils. 

Fever (over 100.0 degrees) is an important symptom. While you can treat the fever, and usually make the child feel better temporarily, the cause of the fever (and the risk of passing an illness to others) is still there. Your child should be fever-free for 24 hours (without medication) before sending him back to school. Remember to only give children under age 18 Tylenol (acetaminophen) or Advil (ibuprofen). Never give ASPIRIN. 

Severe cough - Children with bad coughs need to stay home, and possibly see a doctor. A bad cough can be a symptom of bronchitis, flu, or pneumonia. Once the child is feeling better, though, send her back to school; don’t wait for the cough to disappear completely, as that could take a week or longer. 

Sore throat -- A minor sore throat is usually not a problem, but a severe sore throat could be strep throat – even if there is no fever (other symptoms of strep throat in children are headache and stomach upset). Keep your child home from school, and contact a doctor. Your child needs a special test to determine if it is strep throat. If he has strep, he can return to school 24 hours after antibiotic treatment begins. 

Diarrhea and vomiting make a child very uncomfortable. A single episode of vomiting, without any other symptoms, may not be reason enough for the child to miss school. PLEASE be sure the school can reach you if symptoms occur again during the day!! A single episode of watery diarrhea warrants staying home. It could be very embarrassing and uncomfortable for your child to have another episode while in school. If diarrhea or vomiting are persistent or are accompanied by fever, rash, or general weakness, consult your physician and keep the child out of school until the illness passes. 

Flu is a contagious virus that usually occurs in the winter months. Symptoms include body aches, high fever, chills, congestion, sore throat, and in some children, vomiting. The child should stay at home until these symptoms subside, usually 5-7 days. Consult your child’s doctor for treatment suggestions to make your child more comfortable. 

Ear infections can cause great discomfort and often fever, but are not thought to be contagious to others. The child should see his doctor for diagnosis and treatment and should stay home if they have fever or pain. 

Pink eye or conjunctivitis can be caused by a virus, bacteria, or allergy. The first two are very contagious. The eye will be reddened, and a cloudy or yellow discharge is usually present. The eye may be sensitive to light. Consult with you child’s doctor to see if antibiotics are needed. Again, the child should stay at home until symptoms subside and they have been on antibiotics at least 24 hours. 

Rash - Children with a skin rash should see a doctor, as this could be one of several infectious diseases. One type of rash often seen in school is ringworm. Ringworm is a contagious fungal infection that has nothing to do with worms. The name comes from the characteristic red ring that can appear on an infected person’s skin. Ringworm can be treated with fungus-killing cream applied directly to the affected area on the body. The child should remain at home until treatment has begun. The affected area must be covered with a Band-Aid while in school. 

All of these illnesses can be easily spread, both in school and at home. Keep in mind that hand washing is the single most important thing you can teach your child to do that will help prevent the spread of infections. 

Remember to always make sure that the school knows how to reach you during the day and that there is a back-up plan and phone number on file in case you cannot be reached.. 

Whenever there is doubt in your mind about sending your child to school, consult your child’s doctor before doing so. A phone consultation may be all that is necessary, or your doctor may need to see the child in the office.
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